Protecting Personal Data in Healthcare: The Importance of Cybersecurity Measures

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As a health insurance agent, you play a critical role in ensuring the protection of the personal data of your clients. Consumers share a vast amount of important information when enrolling for health insurance. This includes social security numbers, citizenship papers, passport info, and banking numbers.

However, the ongoing threat of cyber attacks in the healthcare industry highlights the need for increased cybersecurity measures to safeguard such sensitive information of Medicare beneficiaries.

The recent CMS ransomware attack and subsequent data leak in 2022 is a clear example of how serious this issue is. Unfortunately, this is not the first time such an attack has occurred. In 2015, HMS Medicare suffered a data breach that exposed the personal data of nearly 400,000 beneficiaries. In 2018, a CMS data breach compromised the personal information of nearly 75,000 individuals on the Healthcare.gov website.

The potential consequences of these data breaches are significant, and the loss of sensitive medical information can severely impact individuals, including reputational damage and emotional distress. Health insurance agents need to ensure that their clients’ data is protected at all costs.

To prevent data breaches from occurring, healthcare providers, including insurance agents, must implement more robust cybersecurity measures. This can include regular security audits, encryption of sensitive information, and employee training on data protection best practices. Organizations must also have a response plan in place in the event of a data breach to minimize the impact of the breach.

The challenge is that as the healthcare industry continues to digitize, the risk of cyber attacks will continue to increase. Agents must take a proactive approach to cybersecurity to stay ahead of these threats. This not only ensures the safety and trust of consumers but also protects the reputation of your organization.

The CMS ransomware attack and subsequent data breach are a clear reminder of the importance of cybersecurity measures in the healthcare industry. Health insurance agents have a critical responsibility to safeguard their clients’ sensitive information. By implementing strong cybersecurity measures and staying ahead of potential threats, you can protect your clients’ data and ensure their safety and trust in the healthcare system.

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The Biden-Harris Administration Celebrates the 13th Anniversary of the Affordable Care Act

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Thirteen years ago, the Affordable Care Act (ACA) was signed into law with the goal of expanding access to affordable and quality healthcare for all Americans. Since then, the ACA has been a cornerstone of the American healthcare system, providing coverage to millions of previously uninsured people.

This year, on the 13th anniversary of the ACA, the Biden-Harris Administration is celebrating the law’s achievements and highlighting the record number of people who have signed up for health insurance through the ACA’s marketplace.

One of the most significant achievements of the ACA is the creation of the Affordable Care Act insurance Marketplace. The Marketplace provides a platform for individuals and small businesses to compare and purchase health insurance plans that meet their needs and budgets. Over the past 13 years, the Marketplace has helped 16 million people gain access to affordable health insurance, and this year’s open enrollment period saw record-high enrollment numbers.

The healthcare marketplace open enrollment period for 2023 began on November 1, 2022, and ended on December 15, 2022. According to the 2023 Open Enrollment Report, released by the Centers for Medicare & Medicaid Services (CMS), over 12 million people enrolled in health insurance plans through the Marketplace during this period. This represents a 23% increase from the previous year’s open enrollment period.

The Biden-Harris Administration has been working tirelessly to improve the ACA and make healthcare more accessible and affordable for all Americans. One of their recent efforts includes expanding eligibility for premium tax credits, which help reduce the cost of health insurance for those who qualify. This expansion is expected to provide additional financial assistance to over four million people.

The Administration has also taken steps to strengthen the ACA’s protections for people with pre-existing conditions, which ensure that they cannot be denied coverage or charged more for their healthcare. Additionally, the Biden-Harris Administration has launched a special enrollment period for those who were affected by the COVID-19 pandemic, providing them with additional opportunities to enroll in health insurance coverage.

The ACA has been a game-changer for millions of Americans, and the Biden-Harris Administration is committed to ensuring that it continues to provide access to affordable and quality healthcare. As we celebrate the 13th anniversary of the Affordable Care Act, we can look back with pride at the progress we have made and look forward to continuing to build a healthcare system that works for everyone.

Agility agents, check out our ACA resources page for more information!

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Medicaid Behavioral Health Coverage: Addressing the Mental Health and Substance Use Crisis

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Mental health and substance use disorders are pervasive in the United States, affecting millions of people each year. In fact, poor mental health is the leading cause of disability worldwide.

According to the National Institute of Mental Health, an estimated 1 in 5 adults in the United States experience a mental illness in any given year, and 1 in 12 adults experience a substance use disorder. These statistics underscore the vital importance of access to quality behavioral health services, including substance use and mental health treatment.

Fortunately, Medicaid provides coverage for many individuals with low incomes, including those with mental health and substance use disorders. Medicaid is the largest payer for behavioral health services in the United States, covering a range of services, including mental health counseling, substance use disorder treatment, and medication-assisted treatment.

However, the extent and quality of Medicaid behavioral health coverage vary significantly from state to state. To better understand the landscape of Medicaid behavioral health coverage, the Kaiser Family Foundation (KFF) conducts annual surveys of state Medicaid programs. In its most recent survey, conducted in 2022, KFF found that states are making progress in expanding access to behavioral health services for Medicaid enrollees, but significant gaps in coverage remain.

For example, while all states cover mental health outpatient services, only 45 states cover residential treatment for substance use disorder. Similarly, while all states cover medication-assisted treatment for opioid use disorder, only 28 states cover medication-assisted treatment for alcohol use disorder. These gaps in coverage can create significant barriers to care for individuals seeking treatment for substance use disorders, particularly those with co-occurring mental health conditions.

Moreover, KFF found that many states have not fully implemented the Medicaid behavioral health parity requirements established by the Affordable Care Act (ACA), which requires that mental health and substance use disorder services be covered at the same level as physical health services. In some cases, states have implemented parity requirements but have not fully enforced them, resulting in disparities in access to care for Medicaid enrollees with behavioral health needs.

The COVID-19 pandemic has also highlighted the critical need for Medicaid behavioral health coverage. The pandemic has increased stress and anxiety for many individuals, leading to a surge in demand for mental health services. According to a survey by the Centers for Disease Control and Prevention, the percentage of adults with recent symptoms of anxiety or depressive disorder increased from 36.4% in August 2020 to 41.5% in February 2021. Medicaid hopes these measures will ensure that individuals with low incomes have access to the behavioral health services they need during this challenging time.

Medicaid plays a critical role in providing access to behavioral health services for individuals with low incomes, including those with mental health and substance use disorders. However, significant gaps in coverage remain, and states must work to fully implement and enforce the Medicaid behavioral health parity requirements established by the ACA. By doing so, states can help to ensure that individuals with behavioral health needs receive the care and support they need to live healthy and fulfilling lives.

Did you know ACA plans cover mental and behavioral health? Get started offering coverage that matters to your clients!

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Exploring the Utilization of Preventive Services by Individuals with Private Insurance Coverage: A Closer Look at Healthcare Prevention

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The Affordable Care Act (ACA) brought many changes to the healthcare industry, including provisions that require most private health plans to cover preventive services at no cost-sharing for their enrollees. This means that individuals with private insurance coverage can receive important preventive services without having to pay out of pocket.

The ACA mandates that private health plans cover in-network preventive services at $0 cost-sharing for enrollees. This includes a wide range of preventive services, such as cancer screenings, vaccinations, and counseling for tobacco use. These services are crucial for maintaining good health and preventing serious illnesses.

According to a report by the Kaiser Family Foundation, the use of preventive services among people with private insurance coverage has increased significantly since the ACA’s implementation. The report found that in 2018, 71% of adults aged 18-64 with private insurance coverage received at least one preventive service.

The provision of free preventive services under the ACA has also helped to reduce healthcare costs in the long run. By catching diseases early and preventing them from developing into more serious conditions, individuals can avoid costly medical treatments and hospitalizations.

It’s important to note that the ACA provisions on preventive services only apply to in-network services. Out-of-network services may not be covered, and cost-sharing may still apply for non-preventive services. Additionally, the ACA’s future is uncertain, and there have been attempts to repeal or replace it in recent years.

The ACA’s coverage of preventive services at no cost-sharing has been a significant benefit for individuals with private health insurance coverage. It has increased the use of preventive services, reduced healthcare costs, and helped to promote overall health and well-being.

Agility agents, are you ACA certified yet? Learn more here!

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How the Medicare Prescription Drug Inflation Reduction Act is Tackling Rising Drug Prices

The Centers for Medicare and Medicaid Services (CMS) recently announced the implementation of a new program called the Medicare Prescription Drug Inflation Reduction Act. This program aims to reduce the rising cost of prescription drugs covered under Medicare Part B. The new program will reduce coinsurance rates for 27 Part B drugs, with savings expected to start from April 1.

The rising cost of healthcare is a growing concern for many Americans, particularly seniors and those with disabilities who rely on Medicare for their healthcare needs. Prescription drugs are a significant component of healthcare costs, and the cost of these drugs has been on the rise for several years. The new program is part of a broader effort by CMS to address the issue of rising drug prices and make healthcare more affordable and accessible.

The Medicare Prescription Drug Inflation Reduction Act is an important initiative that is expected to benefit millions of Americans. The savings from reduced coinsurance rates are expected to be significant, with beneficiaries potentially saving thousands of dollars each year.

The Part B rebates program is just one part of a larger initiative by CMS to reduce healthcare costs for seniors and those with disabilities. In addition to reducing coinsurance rates, CMS is also working to negotiate prices directly with drug manufacturers. By negotiating prices, Medicare hopes to pass on the savings to beneficiaries, making healthcare more affordable and accessible.

The issue of rising drug prices is not unique to the United States. Countries all over the world are grappling with the same issue, and many have taken steps to address it. One solution that has been implemented in several countries is the use of reference pricing. Under this system, the government sets a price for a particular drug, and drug manufacturers are required to sell the drug at that price. Some experts believe that reference pricing could be a solution to the rising cost of drugs in the US.

Another solution that has been proposed is allowing Medicare to negotiate prescription drug prices directly with drug manufacturers. Currently, Medicare is not allowed to negotiate prices, which means that beneficiaries often have to pay high prices for necessary medications. Allowing Medicare to negotiate prices could potentially save billions of dollars each year.

The issue of rising drug prices is complex and multifaceted, and there is no single solution that will solve the problem. However, initiatives like the Medicare Prescription Drug Inflation Reduction Act are an important step towards making healthcare more affordable and accessible for all Americans.

As healthcare agents, it is essential to stay informed about new initiatives like the Medicare Prescription Drug Inflation Rebate Program. By staying informed, agents can provide their clients with the latest information and help them make informed decisions about their healthcare. Healthcare agents play a vital role in helping clients navigate the often-confusing world of healthcare. Initiatives like the Medicare Prescription Drug Inflation Rebate Program can be an important tool in that effort.

The MPDIRA is an essential initiative that aims to reduce the rising cost of prescription drugs covered under Medicare Part B. This program will reduce coinsurance rates for multiple Part B drugs, potentially saving beneficiaries thousands of dollars each year. The program is part of a broader effort by CMS to reduce healthcare costs for seniors and those with disabilities. As healthcare agents, it is essential to stay informed about new initiatives like this one and help clients make informed decisions about their healthcare.

Are you contracted to sell Medicare plans yet? Learn more here!

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Moderna to Provide Free COVID Vaccines to Uninsured Individuals Once State of Emergency Conclude

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As a health insurance agent, you may be wondering about the latest updates on COVID-19 vaccination coverage for uninsured individuals. In recent news, Moderna has announced that they will be offering free COVID-19 shots to those who are uninsured once the state of emergency ends.

This is great news for those who may not have access to health insurance or may be struggling to pay for medical expenses. With the ongoing pandemic, it’s important to ensure that everyone has access to the necessary resources for staying healthy and protected.

As an insurance agent, you can inform your clients about this development and advise them on how to take advantage of this opportunity. Encourage them to stay up-to-date on local news and guidelines regarding the vaccination process, and remind them of the importance of getting vaccinated to protect themselves and those around them.

Additionally, this news highlights the ongoing need for comprehensive health insurance coverage, especially during times of crisis. As a health insurance agent, you can provide guidance on finding the right insurance plan that meets the unique needs of each client, including coverage for vaccinations, hospitalization, and other medical expenses.

Moderna’s announcement to offer free COVID-19 shots to the uninsured is a positive step forward in ensuring that everyone has access to the necessary resources for staying healthy and protected during the ongoing pandemic.

Learn why so many agents are delighted to be a part of the Agility family!

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What to Know About Extended Medicaid Coverage for Mothers

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Health insurance agents, we have some great news to share with you that can benefit your clients. Several states have extended their Medicaid coverage program for postpartum care, allowing new mothers to access crucial healthcare services after giving birth.

As you know, the Affordable Care Act (ACA) provides states with the option to expand their Medicaid coverage for new mothers up to a year after childbirth, instead of the usual 60-day limit. Currently, 17 states (plus Washington, D.C.) have implemented the expansion program, and more states are expected to follow suit in the near future.

As an agent, it’s important to be aware of the expanding postpartum Medicaid coverage program and inform your clients of this option. Many new mothers may not be aware of this extension and could miss out on the opportunity to receive necessary medical attention during the first year of their child’s life.

Under the extension program, new mothers have access to services such as routine check-ups, mental health support, and family planning services. This can make a significant difference in their postpartum healthcare journey and ultimately lead to better health outcomes for both mother and child.

If you have clients who are new mothers or expecting, be sure to inform them of the postpartum coverage extension and encourage them to take advantage of it. If you’re not sure if your state has implemented the program, check with your local Medicaid office or healthcare provider to find out.

By staying informed and educating your clients on the expanding postpartum Medicaid coverage program, you can help improve their access to healthcare services and ensure they receive the best possible care during this important time in their lives.

Are you familiar with Medicaid Unwinding?

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Agility Partners with Ameritas Dental and Vision!

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Are your customers looking for a stand-alone dental and vision carrier that offers simple plans, a wide range of benefits, and a large network of providers? They need not look further than Ameritas, now partnered with Agility Insurance Services.

Ameritas has been offering dental coverage since 1959 and vision coverage since 1984. With $400 million in individual dental and vision plans available in all 50 states, Ameritas has become a trusted name in the industry. But what sets Ameritas apart from other carriers?

First and foremost, Ameritas focuses on simplicity, ease of enrollment, and member value. They offer a variety of plans that include implant coverage, teeth whitening, LASIK, hearing care, and Preventive Plus. With online enrollment and next-day benefits, consumers will immediately start enjoying the advantages of these benefits.

Ameritas also has an extensive network of providers. Their dental network boasts over 582,000 access points, 131,000 providers, and 93,000 locations across the United States and Mexico. With 25-50% savings compared to typical fees, your customers can rest assured that they are getting the best value for their money. For vision coverage, Ameritas partners with VSP and EyeMed network plans, giving you even more options.

But what if your clients are replacing a fully insured dental plan from another carrier? Ameritas offers Credit for Prior Coverage (CPC), as long as the gap in coverage is no more than 60 days from the Ameritas plan effective date, and the previous policy number and carrier name are provided during enrollment. This means customers can enjoy increased benefits, including year 2 plan benefits (coinsurance) on day one for Preventive, Basic, and Major dental services, based on the chosen plan.

Overall, Ameritas is an excellent choice for those looking for a stand-alone dental and vision carrier. With their focus on simplicity, value, and provider network, you as a health insurance agent can feel confident that your customers are getting the best coverage.

Are you ready and contracted to sell Ameritas plans?

Agility Producer Support
(866) 590-9771
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A Guide To High vs Low Deductibles for Health Insurance Plans

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Regarding health insurance plans, one of the most important things for your customers to understand is the difference between high and low deductibles. Understanding this difference between high and low deductibles can help your clients make an informed decision when selecting a health insurance plan. Here are 8 things for your customers to consider when comparing high vs low deductibles:

Cost: 

High deductibles generally mean lower monthly premiums, while low deductibles typically mean higher monthly premiums. Depending on your budget and healthcare needs, customers need to weigh the pros and cons of higher and lower deductibles to determine what’s best for their situation.

Coverage: 

High deductible plans tend to have higher out-of-pocket costs and fewer covered services, while low deductible plans may have more comprehensive coverage but with higher monthly premiums.

Maximum out-of-pocket expenses: 

High deductible plans tend to have higher maximum out-of-pocket expenses, while low deductible plans tend to have lower maximum out-of-pocket expenses. This is an essential factor for clients to consider when selecting a plan.

Tax benefits: 

Some high-deductible plans are eligible for tax benefits. Depending on the situation, these tax benefits could make a high-deductible plan more attractive to customers than a low-deductible plan.

What services are covered: 

Be sure to look closely at what services are covered under a high-deductible plan vs a low-deductible plan. Make sure you understand how the plan works and what services are covered before enrolling.

Copayments and coinsurance: 

Copayments and coinsurance vary among plans and can affect how much clients pay out-of-pocket. In a high deductible plan, customers may pay more out-of-pocket than in a low deductible plan.

Network coverage: 

Network coverage is important to consider when selecting a plan. High deductible plans may have more limited network coverage, so make sure your customers look closely at the provider networks available under each plan.

Prescription drug coverage: 

Many high-deductible plans have limited prescription drug coverage and may require clients to pay more out-of-pocket for their medications. Make sure to remind clients to look closely at prescription drug coverage before enrolling in a plan

When selecting a health insurance plan, it is crucial for shoppers to understand the differences between high and low deductibles. Remind your customers that high-deductible plans can be more cost-effective but may have higher out-of-pocket expenses and more limited coverage. Meanwhile, shoppers should remember that low deductible plans often have higher premiums but more comprehensive coverage. Understanding the benefits and limitations of each option can help consumers make an informed decision that best fits their healthcare needs and budgets.

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Everything Your Customers Need to Know About How Employer-Sponsored Health Plans Compare to Medicare for Prescription Drug Costs

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When it comes to prescription drug costs, there can be significant differences between employer-sponsored health plans and Medicare. Understanding the differences between the two can help your clients save money and ensure you help them get the coverage they need. Here’s what your customers need to know about employer-sponsored health plans and Medicare.

Cost: 

Generally speaking, employer-sponsored plans tend to pay more for drugs than Medicare. This is because employers often negotiate discounts with drug manufacturers, allowing them to offer lower drug costs than Medicare.

Coverage: 

Employer-sponsored health plans may provide more comprehensive coverage for prescription drugs than Medicare. Some employer-sponsored plans may cover drugs not covered by Medicare.

Out-of-pocket costs: 

While employer-sponsored health plans may pay more for drugs than Medicare, they may also require higher out-of-pocket costs. Employer-sponsored plans may have higher co-pays, coinsurance, and deductibles than Medicare.

Formularies: 

Employer-sponsored health plans and Medicare may have different formularies, which are lists of drugs that are covered and excluded. Make sure customers check the formularies for both types of plans before making a decision.

Specialty drugs: 

Many employer-sponsored plans have higher copays and coinsurance for specialty drugs. Medicare, on the other hand, has lower copays and coinsurance for specialty drugs.

Prior authorization: 

Employer-sponsored plans may require prior authorization for certain drugs, while Medicare generally does not.

Step therapy: 

Employer-sponsored health plans may require step therapy for certain drugs, while Medicare does not.

Employer-sponsored health plans and Medicare can have significant differences as far as prescription drug costs. Understanding the differences can help customers make an informed decision about which plan is best for them. Make sure to emphasize to clients that they should compare the cost, coverage, and out-of-pocket expenses for each plan before making a decision.

Your next step as an agent is to learn how Medicare Advantage Plans (MAPD) and Prescription Drug Plans (Part D) play a role in helping your clients control their prescription drug costs. Work with Agility to learn more!

Are you contracted to sell Medicare plans yet? Contact us to get started today!

Agility Producer Support
(866) 590-9771
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